CNR ExploRA

Articolo in rivista, 2020, ENG, 10.1016/j.jad.2020.03.075

Factors Associated With Loneliness: An Umbrella Review Of Observational Studies

Solmi M.; Veronese N.; Galvano D.; Favaro A.; Ostinelli E.G.; Noventa V.; Favaretto E.; Tudor F.; Finessi M.; Shin J.I.; Smith L.; Koyanagi A.; Cester A.; Bolzetta F.; Cotroneo A.; Maggi S.; Demurtas J.; De Leo D.; Trabucchi M.

Neurosciences Department, University of Padua, Padua, Italy; Neuroscience Center, University of Padua, Padua, Italy; Azienda ULSS 3 (Unità Locale Socio Sanitaria) "Serenissima", Primary Care Department, Dolo-Mirano District, Venice, Italy; XIV Corso di Formazione Specifica in Medicina Generale, Scuola di Sanità Pubblica (SSP), Veneto Region, Venice, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy; Department of Mental Health, ASST Santi Paolo e Carlo, Milan, Italy; Social Service, Spinea City, SpineaVenice, Italy; Relaxxi SRL, Noale, Venice, Italy; Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea; The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain; Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", Dolo-Mirano District, Italy; Dir. SC Geriatric Unit Hospital Maria Vittoria Turin - ASL Città di Torino; Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Primary Care Department, Azienda USL Sud Est Toscana - Grosseto; Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt Campuss, Australia; University Tor Vergata, Rome, Italy

Background: Evidence provides inconsistent findings on risk factors and health outcomes associated with loneliness. The aim of this work was to grade the evidence on risk factors and health outcomes associated with loneliness, using an umbrella review approach. Methods: For each meta-analytic association, random-effects summary effect size, 95% confidence intervals (CIs), heterogeneity, evidence for small-study effect, excess significance bias and 95% prediction intervals were calculated, and used to grade significant evidence (p<0.05) from convincing to weak. For narrative systematic reviews, findings were reported descriptively. Results: From 210 studies initially evaluated, 14 publications were included, reporting on 18 outcomes, 795 studies, and 746,706 participants. Highly suggestive evidence (class II) supported the association between loneliness and incident dementia (relative risk, RR=1.26; 95%CI: 1.14-1.40, I2 23.6%), prevalent paranoia (odds ratio, OR=3.36; 95%CI: 2.51-4.49, I2 92.8%) and prevalent psychotic symptoms (OR=2.33; 95%CI: 1.68-3.22, I2 56.5%). Pooled data supported the longitudinal association between loneliness and suicide attempts and depressive symptoms. In narrative systematic reviews, factors cross-sectionally associated with loneliness were age (in a U-shape way), female sex, quality of social contacts, low competence, socio-economic status and medical chronic conditions. Limitations: Low quality of the studies included; mainly cross-sectional evidence. Conclusions: This work is the first meta-evidence synthesis showing that highly suggestive and significant evidence supports the association between loneliness and adverse mental and physical health outcomes. More cohort studies are needed to disentangle the direction of the association between risk factors for loneliness and its related health outcomes

Journal of affective disorders (Print) 271 , pp. 131–138